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Performance of nested RT-PCR on CSF for tuberculous meningitis diagnosis in HIV-infected patients
Gualberto, F. A. S; Gonçalves, M. G; Fukasawa, L. O; Santos, A. M. Ramos dos; Sacchi, C. T; Harrison, L. H; Boulware, D. R; Vidal, José Ernesto.
Afiliação
  • Gualberto, F. A. S; Universidade de São Paulo. Faculdade de Medicina. São Paulo. BR
  • Gonçalves, M. G; Secretaria de Estado da Saúde. São Paulo. Instituto Adolfo Lutz. São Paulo. BR
  • Fukasawa, L. O; Secretaria de Estado da Saúde. São Paulo. Instituto Adolfo Lutz. São Paulo. BR
  • Santos, A. M. Ramos dos; Secretaria de Estado da Saúde. São Paulo. Instituto de Infectologia Emílio Ribas. São Paulo. BR
  • Sacchi, C. T; Secretaria de Estado da Saúde. São Paulo. Instituto Adolfo Lutz. São Paulo. BR
  • Harrison, L. H; University of Pittsburgh. Pittsburgh. US
  • Boulware, D. R; University of Minnesota. Department of Medicine. Minneapolis. US
  • Vidal, José Ernesto; Secretaria de Estado da Saúde. São Paulo. Instituto de Infectologia Emílio Ribas. São Paulo. BR
Int. j. tuberc. lung dis ; 21(10): 1139-1144, Oct. 2017. ilus, tab
Article em En | SES-SP | ID: biblio-1023416
Biblioteca responsável: BR31.1
ABSTRACT

SETTING:

Timely diagnosis of tuberculous meningitis (TBM) in patients with human immunodeficiency virus (HIV) infection remains a challenge. Despite the current scale-up of the Xpert® MTB/RIF assay, other molecular diagnostic tools are necessary, particularly in referral centres in low- and middle-income countries without Xpert testing.

OBJECTIVE:

To determine the diagnostic performance of nested real-time polymerase chain reaction (nRT-PCR) in HIV-infected TBM patients categorised according to standardised clinical case definitions.

DESIGN:

Based on clinical, laboratory and imaging data, HIV-infected patients with suspected TBM were prospectively categorised as 'definite TBM', 'probable TBM', 'possible TBM' or 'not TBM'. We evaluated nRT-PCR sensitivity and specificity in diagnosing TBM among definite TBM cases, and among definite + probable TBM cases.

RESULTS:

Ninety-two participants were enrolled in the study. nRT-PCR sensitivity for definite TBM (n = 8) was 100% (95%CI 67-100) and 86% (95%CI 60-96) for both definite and probable TBM (n = 6). Assuming that 'not TBM' patients (n = 74) were true-negatives, nRT-PCR specificity was 100% (95%CI 95-100). The possible TBM group (n = 4) had no nRT-PCR positives.

CONCLUSIONS:

The nRT-PCR is a useful rule-in test for HIV-infected patients with TBM according to international consensus case definitions. As nRT-PCR cannot exclude TBM, studies comparing and combining nRT-PCR with other assays are necessary for a rule-out test
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Texto completo: 1 Coleções: 06-national / BR Base de dados: SES-SP Assunto principal: Tuberculose Meníngea / Infecções por HIV / Reação em Cadeia da Polimerase Tipo de estudo: Diagnostic_studies Limite: Humans Idioma: En Revista: Int. j. tuberc. lung dis Ano de publicação: 2017 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
Imprimir
XML
Buscar no Google

Texto completo: 1 Coleções: 06-national / BR Base de dados: SES-SP Assunto principal: Tuberculose Meníngea / Infecções por HIV / Reação em Cadeia da Polimerase Tipo de estudo: Diagnostic_studies Limite: Humans Idioma: En Revista: Int. j. tuberc. lung dis Ano de publicação: 2017 Tipo de documento: Article